1. ©2011 National Association of Social Workers. All Rights Reserved. 1 Adolescent Depression and Suicide: What Social Workers Need to Know Sharon S. Issurdatt, DCSW, ACSW, LCSW NASW Social Work Practice Department May 12, 2011

2. Overview Recognize symptoms of depression and risk factors for suicide in adolescents. Understand the dynamics of bullying and how to work with children involved. Learn how to manage a suicidal adolescent. ©2011 National Association of Social Workers. All Rights Reserved. 2

3. Poll: How many social workers participating today feel confident managing a suicidal adolescent? ©2011 National Association of Social Workers. All Rights Reserved. 3

4. Suicide In 2007, suicide was the third leading cause of death among young people ages 15 to 24 (MIMH, 2010). ©2011 National Association of Social Workers. All Rights Reserved. 4 SuicideHomicides Unintentional Accidents

5. Statistics Bullied teens are more likely to abuse drugs or alcohol, more likely to skip school and more likely to be depressed (Health and Human Services Office of HIV/AIDS Policy on Bullying and Teen Suicide, 2010). More than 90% of people who die by suicide have depression, other mental disorders or a substance-abuse disorder (National Institute on Mental Health, 2010). ©2011 National Association of Social Workers. All Rights Reserved. 5

6. According to a 2009 report by NASW: Young people who acknowledge using alcohol or illicit substances evidence a higher likelihood of committing suicide. More than three-fourths of adolescent suicide deaths are associated with mental illness. There is one suicide for every 100 to 200 attempts among 15 – 24 year-old young adults. ©2011 National Association of Social Workers. All Rights Reserved. 6

7. NASW 2009 report continued… Suicide occurs 33 percent more often than homicide in the general population. State governments spend about $900 million dollars per year on medical costs associated with completed suicides, and suicide attempts by individuals up to 20 years old. ©2011 National Association of Social Workers. All Rights Reserved. 7

8. Who is at risk? Research has shown that young females are more likely to ATTEMPT suicide while young males are more likely to COMMIT suicide. ©2011 National Association of Social Workers. All Rights Reserved. 8

9. The National Adolescent Health Information Center’s 2006 Fact Sheet on Suicide of Adolescents and Young Adults American Indian/Alaskan Native male adolescents have the highest suicide rate. Female Hispanic adolescents are more likely to attempt suicide than their peers. ©2011 National Association of Social Workers. All Rights Reserved. 9

10. The National Adolescent Health Information Center’s 2006 Fact Sheet on Suicide of Adolescents and Young Adults continued… Suicide rates increase dramatically between early adolescence and young adulthood. The suicide rates for young adult males have fallen sharply in the past decade. ©2011 National Association of Social Workers. All Rights Reserved. 10

11. Risk Factors and Symptoms Changes in Mood Changes in Eating Patterns Changes in Sleeping Patterns Changes in School Achievement Changes in School Attendance ©2011 National Association of Social Workers. All Rights Reserved. 11

12. Risk Factors and Symptoms Changes in Interest in Social Interactions Changes in Personal Hygiene or Dress Violence Running Away Drug and/or Alcohol Use ©2011 National Association of Social Workers. All Rights Reserved. 12

13. Risk Factors and Symptoms Physical Complaints Inability to Tolerate Positive Interactions or Praise Fatigue and/or Lethargy Taking Excessive Risks Sense of Hopelessness Having a Family Member Who Has Committed Suicide ©2011 National Association of Social Workers. All Rights Reserved. 13

14. Characteristics of Bullying Behavior: Hurtful Actions or Words RepeatedIntentional Aimed to Intimidate Aimed to Humiliate ©2011 National Association of Social Workers. All Rights Reserved. 14

15. Bullying is different from normal conflict. Repetitive Intent to Harm Invokes Terror Imbalance of Power Abusive ©2011 National Association of Social Workers. All Rights Reserved. 15

16. Cyber bullying Stop Bullying Now (2010) defines cyber bullying as bullying through the use of the internet, mobile phones, or other forms of cyber technology. Can be in the form of mean text messages, emails, or instant messages, posting obscene pictures or messages in blogs or websites, including social networking sites. ©2011 National Association of Social Workers. All Rights Reserved. 16

17. Who is at risk of being bullied? ©2011 National Association of Social Workers. All Rights Reserved. 17 Every student has the risk of being bullied during their school years. Students often experience participating in bullying behaviors AND being the person who is bullied.

18. Students often most at risk: Nearly one-fourth of students in elementary through high school have reported that they have been harassed or bullied on school property because of their race, ethnicity, gender, religion, sexual orientation, or disability. More than 91% of LGBT students say they hear homophobic slurs or expressions frequently or often. More than 64% of LGBT students say they feel unsafe at school because of their sexual orientation. ©2011 National Association of Social Workers. All Rights Reserved. 18

19. Responses to bullying behaviors are often guided by: A misunderstanding of the dynamics of bullying Fear of something tragic happening Viewing students who bully other students as “bad kids” from “bad families” ©2011 National Association of Social Workers. All Rights Reserved. 19

20. Responses to bullying behavior are often: Limited and rigid A “one size fits all” approach Aimed at only eliminating maladaptive behaviors Punitive Disengaging to students ©2011 National Association of Social Workers. All Rights Reserved. 20

21. Responses that have been proven effective in managing bullying behaviors Decline the use of labels of “victim” and “bully” Approach students individually for discussion of events Use approaches that foster school- student connectedness ©2011 National Association of Social Workers. All Rights Reserved. 21

22. Adolescent Depression and Suicide: What Can Social Workers Do? Be comfortable talking about the topic Utilize a Team Approach Provide teachers and school personnel with specific training Provide education to parents Begin anti-bullying and suicide awareness programs ©2011 National Association of Social Workers. All Rights Reserved. 22

23. Adolescent Depression and Suicide: What Can Social Workers Do? Provide Clinical Services Offer Resources Collaborate with other professionals Network with community agencies Stay current with shifting trends regarding youth ©2011 National Association of Social Workers. All Rights Reserved. 23

24. Essential Methods Take every suicide warning seriously. Manage suicide risk with other professionals. ©2011 National Association of Social Workers. All Rights Reserved. 24

25. Resources to Know American Educational Research Association has conducted research regarding keeping schools safe and preventing youth violence. www.aera.netwww.aera.net National Center for Youth Issues addresses social, emotional and psychological dimensions of child development and offers information regarding bullying and school violence on their website. www.ncyi.orgwww.ncyi.org National Suicide Prevention Lifeline is a free, 24 hour hotline available to anyone in suicidal crisis or emotional distress. Calls are routed to the nearest crisis center. There is a network of 140 crisis centers nationwide. www.suicidepreventionlifeline.orgwww.suicidepreventionlifeline.org ©2011 National Association of Social Workers. All Rights Reserved. 25

26. Resources to Know Stop Bullying Now is a campaign through the U.S. Department of Health and Human Services that educates parents, children and teachers about bullying and what can be done to stop it. www.stopbullyingnow.hrsa.gov www.stopbullyingnow.hrsa.gov Issurdatt, S. (2010). A shift in approach: Addressing bullying in schools. Washington, DC: NASW Press. Issurdatt, S. (2011). Adolescent Depression and Suicide Risk: How social workers can make a difference. Washington, DC: NASW Press ©2011 National Association of Social Workers. All Rights Reserved. 26

27. Question and Answer Session ©2011 National Association of Social Workers. All Rights Reserved. 27